Research Directions

Researching the Puzzles of Chronic Pain

Over 100 million people in the United States suffer from chronic pain. Unfortunately, the treatment profile for many chronic pain conditions is complex and often inadequate. Part of this problem lies in the unknown mechanisms of chronic pain development and control. The Chronic Pain Research Consortium strives to resolve these unknown mechanisms through a collaborative and focused approach to basic science pain research. We are using knowledge from clinicians and patients to ask targeted questions related to pain and pain processing. This approach is inspired in part by the founder of this consortium, who is a chronic pain patient. We believe that current pain management is not adequate for providing long term relief of chronic pain and that better and safer medicines are needed. Below are some of the areas currently being studied by investigators at the Consortium. We are aiming to approach each of the areas in multidiciplinary and wholistic ways, rather than in a purely isolated mechanistic or molecular approach.

Immune System

Recent studies indicate that the interaction between the nervous system and immune system is more intertwined than originally thought and goes beyond basic inflammatory responses. The interaction between the two systems involves shared chemical signals and mechanisms. It is now well appreciated that nervous system has profound effects on immune system function. Investigators in the Consortium are studying how this interaction can be used to modulate the whole body responses to chronic pain. Further, investigators are testing how the presence of a chronic pain condition along with associated nervous system and immune system changes may make an individual more susceptible to other chronic illnesses and a decreased quality of life.

Stress

In recent years, the dynamic interaction between pain management and stress has been identified. For many pain patients, stress or negative emotion can dramatically alter their pain. Furthermore, many chronic pain conditions are actually associated with stress-related pathology (e.g. major depression, anxiety disorders, PTSD). Understanding the anatomical and molecular links between stress and pain can provide a new set of tools for the effective treatment of a variety of pain-like conditions. Researchers in the Consortium are using optogenetics, conditional knockout technology, and cutting-edge behavioral approaches to dissect the interaction between stress and pain.

Cancer

Intensive pain is a serious problem in cancer treatment, recovery, and end-of-life management. During treatment, severe pain is one of the most important limiting factors for chemotherapeutic dosing. Understanding the mechanisms of chemotherapy-induced pain has enormous therapeutic potential. During recovery, a number of chemotherapy regimens are associated with chronic peripheral neuropathy. Determining the cause of this neuropathy could allow patients to live pain-free following primary treatment of their cancer. Finally, there is often enormous pain for patients with terminal cancer. Although the use of narcotics (e.g. morphine) can be effective for many patients, the doses required for adequate pain management often are associated with significant physiological and cognitive side-effects, making the reliance on these drugs problematic. Investigators in the Consortium are using innovative imaging approaches coupled with behavioral analysis to determine the relation between cancer, chemotherapy, and chronic pain.

Psychology

"Pain is inevitable. Suffering is optional" says the Zen Proverb. As we are searching for new medicines, chronic pain is still present in the lives of millions of people. One of the less fully appreciated sources of chronic pain relief is from cognitive-based therapy. We are interested in determining what role psychology, attitude, spirituality, and overall life attitude play in chronic pain treatment success and recovery. The founding of the Consortium is inspired by the founder's personal experience that only a comprehensive, wholistic approach to chronic pain treatment can provide sustained relief. Therefore, the research interests of the Consortium include understanding how cognition affects chronic pain etiology and treatment outcomes.

Health Education

Members of the CPRC are interested in devising new methods to teach students in health professions about treating and understanding pain. Some of this research involves the development of innovative course work meant to bring together different fields of study. For example, a current course involves both pharmaceutical sciences students and nursing students so that each group will have a better appreciation of the needs of the other in the treatment of pain. In addition, the CPRC runs the Pain Undergraduate Research Experience (PURE) summer research program. This unique summer program introduces undergraduate researchers to pain research and gives students the opportunity to connect their research with the experiences of physician scientists and patients.

Funding

Consortium members have received research funding from all of the following organizations and foundations: